Job Summary
We are seeking a proactive and detail-oriented Preauthorization Specialist to join our dynamic Plastic and Reconstructive Surgery team. In this vital role, you will be responsible for obtaining prior approval from insurance companies and other payers for medical procedures, treatments, and services. Your expertise will ensure that patients receive timely care while maintaining compliance with insurance policies and regulations. This position offers an exciting opportunity to make a meaningful impact on patient care coordination and streamline the authorization process.
Responsibilities
- Review medical documentation, patient records, and provider requests to determine authorization eligibility
- Communicate directly with insurance companies to obtain preauthorization approvals for various medical services
- Verify patient insurance coverage and eligibility prior to submitting authorization requests
- Maintain accurate records of all authorization requests, approvals, denials, and related correspondence
- Collaborate with healthcare providers, patients, and insurance representatives to resolve authorization issues promptly
- Utilize specialized financial software to track submissions, monitor statuses, and generate reports
- Follow up on pending authorizations to ensure timely processing and escalate issues as needed
Requirements
- Proven experience in healthcare insurance preauthorization or related administrative roles
- Strong knowledge of insurance policies, medical terminology, and authorization procedures
- Excellent communication skills for liaising with insurance companies, providers, and patients
- Ability to navigate financial software efficiently and accurately record data
- Detail-oriented with strong organizational skills to manage multiple requests simultaneously
- High school diploma or equivalent; additional certification in healthcare administration is a plus
- Nice-to-have: familiarity with electronic health records (EHR) systems and billing processes
Join us in delivering exceptional service by ensuring that our patients receive the care they need without unnecessary delays. Your dedication will help optimize the authorization process while supporting our mission to provide accessible healthcare solutions.
Pay: From $20.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Paid time off
Work Location: In person
